WITHDRAWAL SYMPTOMS - MIRTEZAPINE

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Hi there. I've been on 15mg Mirtazapine for 5 years and decided (along with my doctor) that it was time to come off them. I'm the heaviest I've ever been and I'm putting that down to these tablets. My doctor gradually took me off them over a period of 4 weeks. 1 every second night for 2 weeks then 1 every third night for 2 weeks. My last tablet was 11 nights ago and the withdrawal symptoms I've been getting for the past week are horrendous. Restless sleep, night sweats, shakes, itching and the worst one is the nausea feeling and not being able to eat. I was going to phone my doctor for advise. Can anyone help? I'm at breaking point as it's knocking me for 6.

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  • Posted

    I think these symptoms are normal although I'm not sure about the itching. I read one person's account that the symptoms lasted about three weeks after stopping them altogether. I've just started the journey after taking Mirtazapine for about 15yrs. I started on 15mg and the weight gain wasn't so obvious but over the years I got heavier and heavier. I consoled myself that I was feeling good so what did it matter being overweight, but now it's become an issue, ive gone up by 4 dress sizes and 4+ stones. Added to that I'm now taking 45mg and the Mirtazapine isn't doing its job.

    I started to decrease them two nights ago, no real symptoms.......yet! I'm intending to keep reducing them slowly, aiming to be off them by about December or January. Hang in there. I'm sure it will be worth it. Good luck.

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    • Posted

      Thank you for your reply. It's the nausea feeling I can't shake off. For the 4 weeks I was reducing them I felt fine. Then 3 days after my last tablet the symptoms started. Here's hoping they disappear soon. Good luck to you too and hope you get on okay x

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  • Posted

    Hi Clara

    I think you have tapered off mirt much to quickly after taking it for 5 years. This is the reason your feeling so unwell. The first time I came off mirt, like you I did it too fast. I had exactly the same symptoms as you. The itching, retching, nausea, crying, anger, shaking and dizziness and depression symptoms made me feel I was going crazy. I had to reinstate 3.75 mirt and instantly felt better. Once stabilised I started slowly tapering again Eg. 1.87 then once stabilised took a crumb of mirt for two weeks. This method gave me no withdrawals at all. Taking mirt every other day or tapering too fast is a recipe for ill health and despair. Please consider reinstating a small amount. The gp's don't seem to understand the devastation when tapering off antidepressants isn't done slowly and giving the brain time to adjust.

    I really wish you better Clara, I understand exactly what you are going through ???

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    • Posted

      Thank you so much for your reply. I was saying to my mum today that maybe the doctor tapered me too quickly. I'm going to phony docs tomorrow to see if he can give me anything for the nausea feeling. Thank you

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  • Posted

    Hi Clara,

    I'm sorry to hear that you are having such strong withdrawal symptons. Over the last year, on this site, several people have shared simular reactions when titrating off Mirtazapine. Many people have advised a very slow titration, there used to be a chart online maybe someone will have a copy.

    I'm going to have to discontinue the Mirtazapine soon and figure  it will take 6 months - I usually make a chart (from Ashon manual) - I have learned that I need to go very slow.

    The Mirtazapine still works but I have gained an insane amount of weight over the years - been on - 15-30 mg for sleep. I'm getting scared of amount of weight, I'm prediabetic now.

    An observation I've made from taking antidepressants and benzos (Clonazapam)  in that doctors make too large a cut for me, too fast.. When I've been encouraged to follow my own titration schedule (with no firm end date), I've done okay.  I have tapered of Mirtazapine twice over 15 years. I just seems for my situation I eventully get prescribed again.

    If you can find a chart online or website that deals with Mirtazapine, it might be very helpful.  A rule of thumb I learned was to stop a downward tritation if the withdrawal symptons are too intense, stay at that dosage for 1-2 weeks (or longer)  The goal is not to increase back to the previous cut. (That being said, one Psychiatrist told  me to cut back to a comfort point and stay at that point for a month. I don't know if this is of any used to you. Wishing you the very best

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  • Posted

    Hi Clara, sorry to hear you're not feeling the greatest. Are you taking any other meds by any chance? 

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    • Posted

      I take medication for hiatus hernia and ibs and also beta blockers which I was going to try and reduce however the way I've been feeling with coming off mirt I'm deffo not going to reduce them just now.

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  • Posted

    Hi All,

    It's so hard to get firm evidence on the safest way to reduce this Mirtazapine. Most of the information I used to convince my GP that I was ready to start reducing and coming off Mirtazapine, and why I thought it would benefit me, was from this forum and one other blog I found. There are no medical evidence sites to assist us. As a nurse I am expected to use evidence based practice, but what do patients do when there is no research to assist us? I've spoken to my GP and pharmacist who both say the evidence is that people can come off it successfully whilst reducing the doses in increments of 7.5mg. Yet nearly all those who've been through this process on this forum state that these increments are too big. I'm more enclined to listen to you, my fellow mirtazapine takers, than professionals who are probably using guess work from a general rule of cut in half then half again etc. It's like we have to do it by ourselves. Thank goodness we can share knowledge here. Thank you @Patient.

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  • Posted

    So sorry to read of your suffering and news of your doctors uneducated guess at tapering Mirtazapine.  You thought you were doing all the right things then the nasty symptoms kick in, such a shame, remember its not your state of mind returning to any previous condition, its your body crying out for the med.

    There used to be the CITA Protocol which followed alternative day/alternative dose but it is outdated, and causes difficulties.  If you google Dr Joseph Glenmullen he will advice to drop 25%, most people (at a guess 75%) can't cope with that.  Best advice, and for an informed choice is to read here :

    For advice on tapering Mirtazapine slowly at the recommended rate of no more than 10% every 3 or 4 weeks, please see the following which is within this forum,

    http://patient.info/forums/discuss/depression-resources-298570

    and then click on the link "REDUCING AD'S USING 10% WITHDRAWAL METHOD".

    I would say the above method is easy to follow and almost 'discontinuation syndrome symptom" free, give or take a little fatigue (for me).  This is the best place to start, once you have gauged any reactions you will know how your body reacts and can cope.

    I've been tapering doing a 5% drop every 2 weeks,sligjhtly kinder to the nervous systom, I know one lady who does 2.5% every week.

    For anyone like yourself who has been on Mirt' for a considerable time, I would take the kindness to yourself route and go slow.  I know several who have triggered instability and not been able to stabilise as they either did CT or dropped too fast.  Some folk on this forum might say "just STOP" saying that they themselves had no symptoms apart from anxiety and insomnia !!!  Well hello ...

    It is cruel to continue like you are with those awful wd symptoms, I would reinstate straight away, you might take 1 day to feel improvement, 4 days or it may be difficult for longer, but as we're all different no one can say.  There seems to be two schools of thought about reinstatement, back at the last dose you felt comfortable at, or to try just a small dose say a quarter of the 15mg ... I wouldn't like to say which is best, but if it were me I think I'd go for 7.5 mg - half the 15mg tablet.

    For anyone who wants a table/chart or further advice using liquid, Sol Tabs etc just shout, they're all available.

    Clara, Mirt' contains a huge histamine block (anti j=histamine) once this is pulled away the body goes into shock - hence the itching, a simple anti histamine (non drowsy) will definately help with this.  Anti nausea is best from the doctor I think, or ask your pharmacy?

    Keep your strength up, smoothies with banana, maybe protein powder, porridge flakes - anything like that - the thing is if you don't east your nervous system will be wired too ... ugh

    Wishing you well.

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  • Posted

    Thank you all very much for your lovely messages of support. Means a lot. I'm going to see how I am over the next couple of days and if no better I'll be phoning doc again to speak to him about it. I do think the 4v weeks tapering has been too soon. Fingers crossed for a better sleep tonight and no sickie feeling tomorrow. Thanks again everyone xx

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  • Posted

    I am asking because just about everyone I've encountered that has a hard time coming off mirtazapine has another medical condition (IBS is a big one) or is taking other meds. 

    I quit mirtazapine cold turkey 8 weeks ago, 45mg for 12 years. I felt weird for less than two weeks then was fine. So now I'm starting to think that it's not mirtazapine, per se, it's more of a perfect storm with other factors, otherwise everyone would have a hard time with mirtazapine. Of course that doesn't help YOU feel better.

    Can you get benzos from your doctor to hep with the discontinuation syndrome, while you quit?

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  • Posted

    Hi Clara I got off mirt too and had sweating nausea and awhile to fall asleep so that is normal mirt was horrible with me caused weight gain which was uncomfortable now I'm dealing with a different medication that's making me miserable so that will be the next one I come off it I'm so tired of pills if only they would work hope things go better for you ??

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  • Posted

    Hi clara ... also going through WDs ... now I am stucked at 7.5mg. Keep us informed!
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